Accuracy and cut-off points of different models of knee extension strength analysis to identify walking performance in individuals with chronic stroke

Rodrigo Rodrigues Gomes Costa; Frederico Ribeiro Neto; Carlos Wellington Gonçalves; Rodrigo Luiz Carregaro

doi:10.1016/j.bjpt.2021.03.002

Accuracy and cut-off points of different models of knee extension strength analysis to identify walking performance in individuals with chronic stroke

Rodrigo Rodrigues Gomes Costa^*, Frederico Ribeiro Neto, Carlos Wellington Gonçalves, Rodrigo Luiz Carregaro

^*Corresponding author for this work

Health Sciences

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Adequate muscle strength is essential for walking performance in individuals with stroke. Objective: To investigate the accuracy of different forms of muscle knee extension strength analysis to identify high or low walking performance in individuals with chronic stroke. Methods: Twenty-eight participants with a chronic stroke for more than six months participated. Independence for walking was judged by measurement of walking performance assessed for comfortable walking speed (CWS), maximum walking speed (MWS), and the Six Minute Walk Test (6MWT). Peak knee extension torque of the paretic side, non-paretic side, sum of the sides (SS), and difference in the sides (DS) was assessed during concentric movements using an isokinetic dynamometer. Results: The equation with greatest predictive capacity for CWS and MWS included the DS as the main predictor (R² of 0.65 and 0.71, respectively, p < 0.05). The variable with the greatest predictive capacity for 6MWT was time since injury (R² of 0.68, p < 0.05). The highest percentile for CWS in the receiver operating characteristic curve of DS was 25 Nm/kg (cut-off: -12.75 for CWS of 0.498 m/s). The 75th percentile of the 6MWT (324.3 m) was used as the cut-off for the SS (2.1 Nm/kg). The area under the curve for CWS was 0.76 (p < 0.05) on the DS and 0.75 (p < 0.05) for 6MWT on the SS. Conclusion: The models of muscle knee extension strength analysis using the SS and DS presented moderate accuracy to identify walking performance in individuals with chronic stroke.

Original language	English
Pages (from-to)	610-616
Number of pages	7
Journal	Brazilian Journal of Physical Therapy
Volume	25
Issue number	5
DOIs	https://doi.org/10.1016/j.bjpt.2021.03.002
Publication status	Published - 1 Sept 2021

Bibliographical note

Funding Information:
Funded in part by the Universidade de Brasília ( UnB) , Master and PhD Program in Physical Education ( PPGEF/UnB) , and by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil ( CAPES; Finance Code 001). The funding source has no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Funding Information:
Funded in part by the Universidade de Bras?lia (UnB), Master and PhD Program in Physical Education (PPGEF/UnB), and by the Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - Brasil (CAPES; Finance Code 001). The funding source has no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Publisher Copyright:
© 2021 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia

Keywords

Gait
Muscle strength
Physical therapy
Stroke rehabilitation

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10.1016/j.bjpt.2021.03.002

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Cite this

@article{ae265f98b3824b17a659999cbf4cb510,

title = "Accuracy and cut-off points of different models of knee extension strength analysis to identify walking performance in individuals with chronic stroke",

abstract = "Background: Adequate muscle strength is essential for walking performance in individuals with stroke. Objective: To investigate the accuracy of different forms of muscle knee extension strength analysis to identify high or low walking performance in individuals with chronic stroke. Methods: Twenty-eight participants with a chronic stroke for more than six months participated. Independence for walking was judged by measurement of walking performance assessed for comfortable walking speed (CWS), maximum walking speed (MWS), and the Six Minute Walk Test (6MWT). Peak knee extension torque of the paretic side, non-paretic side, sum of the sides (SS), and difference in the sides (DS) was assessed during concentric movements using an isokinetic dynamometer. Results: The equation with greatest predictive capacity for CWS and MWS included the DS as the main predictor (R2 of 0.65 and 0.71, respectively, p < 0.05). The variable with the greatest predictive capacity for 6MWT was time since injury (R2 of 0.68, p < 0.05). The highest percentile for CWS in the receiver operating characteristic curve of DS was 25 Nm/kg (cut-off: -12.75 for CWS of 0.498 m/s). The 75th percentile of the 6MWT (324.3 m) was used as the cut-off for the SS (2.1 Nm/kg). The area under the curve for CWS was 0.76 (p < 0.05) on the DS and 0.75 (p < 0.05) for 6MWT on the SS. Conclusion: The models of muscle knee extension strength analysis using the SS and DS presented moderate accuracy to identify walking performance in individuals with chronic stroke.",

keywords = "Gait, Muscle strength, Physical therapy, Stroke rehabilitation",

author = "{Gomes Costa}, {Rodrigo Rodrigues} and {Ribeiro Neto}, Frederico and Gon{\c c}alves, {Carlos Wellington} and Carregaro, {Rodrigo Luiz}",

note = "Funding Information: Funded in part by the Universidade de Bras{\'i}lia ( UnB) , Master and PhD Program in Physical Education ( PPGEF/UnB) , and by the Coordena{\c c}{\~a}o de Aperfei{\c c}oamento de Pessoal de N{\'i}vel Superior - Brasil ( CAPES; Finance Code 001). The funding source has no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Funding Information: Funded in part by the Universidade de Bras?lia (UnB), Master and PhD Program in Physical Education (PPGEF/UnB), and by the Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - Brasil (CAPES; Finance Code 001). The funding source has no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2021 Associa{\c c}{\~a}o Brasileira de Pesquisa e P{\'o}s-Gradua{\c c}{\~a}o em Fisioterapia",

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doi = "10.1016/j.bjpt.2021.03.002",

language = "English",

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journal = "Brazilian Journal of Physical Therapy",

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Accuracy and cut-off points of different models of knee extension strength analysis to identify walking performance in individuals with chronic stroke. / Gomes Costa, Rodrigo Rodrigues; Ribeiro Neto, Frederico; Gonçalves, Carlos Wellington et al.
In: Brazilian Journal of Physical Therapy, Vol. 25, No. 5, 01.09.2021, p. 610-616.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - Accuracy and cut-off points of different models of knee extension strength analysis to identify walking performance in individuals with chronic stroke

AU - Gomes Costa, Rodrigo Rodrigues

AU - Ribeiro Neto, Frederico

AU - Gonçalves, Carlos Wellington

AU - Carregaro, Rodrigo Luiz

N1 - Funding Information: Funded in part by the Universidade de Brasília ( UnB) , Master and PhD Program in Physical Education ( PPGEF/UnB) , and by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil ( CAPES; Finance Code 001). The funding source has no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Funding Information: Funded in part by the Universidade de Bras?lia (UnB), Master and PhD Program in Physical Education (PPGEF/UnB), and by the Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - Brasil (CAPES; Finance Code 001). The funding source has no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Publisher Copyright: © 2021 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia

PY - 2021/9/1

Y1 - 2021/9/1

N2 - Background: Adequate muscle strength is essential for walking performance in individuals with stroke. Objective: To investigate the accuracy of different forms of muscle knee extension strength analysis to identify high or low walking performance in individuals with chronic stroke. Methods: Twenty-eight participants with a chronic stroke for more than six months participated. Independence for walking was judged by measurement of walking performance assessed for comfortable walking speed (CWS), maximum walking speed (MWS), and the Six Minute Walk Test (6MWT). Peak knee extension torque of the paretic side, non-paretic side, sum of the sides (SS), and difference in the sides (DS) was assessed during concentric movements using an isokinetic dynamometer. Results: The equation with greatest predictive capacity for CWS and MWS included the DS as the main predictor (R2 of 0.65 and 0.71, respectively, p < 0.05). The variable with the greatest predictive capacity for 6MWT was time since injury (R2 of 0.68, p < 0.05). The highest percentile for CWS in the receiver operating characteristic curve of DS was 25 Nm/kg (cut-off: -12.75 for CWS of 0.498 m/s). The 75th percentile of the 6MWT (324.3 m) was used as the cut-off for the SS (2.1 Nm/kg). The area under the curve for CWS was 0.76 (p < 0.05) on the DS and 0.75 (p < 0.05) for 6MWT on the SS. Conclusion: The models of muscle knee extension strength analysis using the SS and DS presented moderate accuracy to identify walking performance in individuals with chronic stroke.

AB - Background: Adequate muscle strength is essential for walking performance in individuals with stroke. Objective: To investigate the accuracy of different forms of muscle knee extension strength analysis to identify high or low walking performance in individuals with chronic stroke. Methods: Twenty-eight participants with a chronic stroke for more than six months participated. Independence for walking was judged by measurement of walking performance assessed for comfortable walking speed (CWS), maximum walking speed (MWS), and the Six Minute Walk Test (6MWT). Peak knee extension torque of the paretic side, non-paretic side, sum of the sides (SS), and difference in the sides (DS) was assessed during concentric movements using an isokinetic dynamometer. Results: The equation with greatest predictive capacity for CWS and MWS included the DS as the main predictor (R2 of 0.65 and 0.71, respectively, p < 0.05). The variable with the greatest predictive capacity for 6MWT was time since injury (R2 of 0.68, p < 0.05). The highest percentile for CWS in the receiver operating characteristic curve of DS was 25 Nm/kg (cut-off: -12.75 for CWS of 0.498 m/s). The 75th percentile of the 6MWT (324.3 m) was used as the cut-off for the SS (2.1 Nm/kg). The area under the curve for CWS was 0.76 (p < 0.05) on the DS and 0.75 (p < 0.05) for 6MWT on the SS. Conclusion: The models of muscle knee extension strength analysis using the SS and DS presented moderate accuracy to identify walking performance in individuals with chronic stroke.

KW - Gait

KW - Muscle strength

KW - Physical therapy

KW - Stroke rehabilitation

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DO - 10.1016/j.bjpt.2021.03.002

M3 - Article

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SN - 1413-3555

VL - 25

SP - 610

EP - 616

JO - Brazilian Journal of Physical Therapy

JF - Brazilian Journal of Physical Therapy

IS - 5

ER -

Accuracy and cut-off points of different models of knee extension strength analysis to identify walking performance in individuals with chronic stroke

Abstract

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